气，善治头痛，所谓头痛必用川芎，各加引经药，今重用之，力专效宏，况其气辛温走窜，上达巅顶，下抵厥阴，合茺蔚子活血明目，稍煎即饮，取其清气上达，为治头痛之妙方，屡试屡验，若合入复方中亦可。
头痛3(高血压)
孙某某，女，37岁
初诊
脉象弦精细数，心烦梦多，大便干结，血压偏高，头痛偏左，痛如针刺。此阴分不足，血虚不能养肝，肝阳化风，风动则头痛必作，舌红且干，阴伤热生之象也。先用清上实下方法。
桑叶10克，菊花10克，勾藤10克(后下)，生石决明20
克，生牡蛎20克，白芍10克，甘草6克，木瓜10克。
二诊
头痛略减，脉象弦细，舌红口干，再以前法，参以养血育阴，冀其风息痛止。
桑叶10克，菊花10克，勾藤10克(后下)，生石决明20克，生牡蛎20克，白芍10克，女贞子10克，旱莲草10克，夏枯草10克，牛膝10克。
三诊
药后痛止眠安，仍以前法进退。忌食辛辣肥甘为要。原方继进10剂。
[按]：阴虚则阳亢，下虚则上盛，令头痛偏左，是肝热上冲，肝热之由，在乎阴虚，故用清肝息风以治其标，养血育阴以治其本，标本兼顾，服之即效。
头痛4(高血压)
周某，女，54岁
初诊
形体削瘦，面色黧黑，木火之形，急躁易怒，每于夜寐欠安则头痛必发，若逢恼怒，其痛更甚。脉象弦细而散，按之有力，阴之不足阳之有余，宣泄其肝热，和其阴分，求其痛止。
柴胡6克，黄芩10克，川楝子10克，竹茹6克，枳壳6
克，白芍10克，勾藤10克，生地黄10克，生石决明20克，生牡蛎20克，七剂
上方服七剂痛减，又继服七剂痛止。
[按]：此案与上案病情相仿，故用药亦大致相同。案中所说木火之形是指形体较瘦削，面色偏黑，性情急躁者，这类患者大多肝火旺而阴分不足，其脉象弦细数，弦乃术郁之象，细主脏阴之亏，数则主热，故断为肝郁热而阴分不足，用泄肝热平肝阳养血育阴方法可效。
头痛5(三叉神经痛)
宁某某，女，42岁
初诊
患三叉神经疼痛有年，曾在神经科治疗。常服镇静剂西药，若停药则头痛即发。面色红赤，舌红唇紫，夜寐梦多，心烦急躁。病属木郁化火，肝热生风，络脉瘀滞之症。先当疏调气机，以解肝郁，用活血通络，以止其痛。
蝉衣6克，僵蚕10克。片姜黄6克，大黄1克，木瓜10克，勾藤10克，大腹皮10克，槟榔10克，珍珠母20克，七剂
二诊
药后痛势稍缓，脉象弦数，按之有力；舌红苔黄唇紫，舌背络脉粗大紫黑，必是血分瘀滞，拟用凉血化瘀通络方：
柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，牛膝10克，川芎20克，勾藤10克(后下)，生石决明20克，生牡蛎20克，珍珠母20克，蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，七剂
三诊
痛势再减，可不服安眠药。夜晚睡眠显著改善，心情较前平静。诊脉弦数，舌红苔白，仍用前法加减。
蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，焦三仙各10克，水红花子10克。川芎20克，七剂
四诊
近因动怒，头痛又作，夜寐不安，恶梦纷纭。五志过极，皆为火热，木火上攻，其痛必作堋I象弦数有力，舌红尖刺苔黄根厚，再以清泄肝胆方法。
柴胡6克，黄芩10克，川楝子10克，龙胆草3克，夏枯草10克，蝉衣6克，值蚕10克，片姜黄6克，大黄2克，黄连2
克，焦三仙各10克，七剂
上方服后，头痛即止。嘱其戒恼怒，忌辛辣，戒烟酒。保持心情舒畅，每日锻炼，以防复发。
[按]：三叉神经痛较为顽固，其人面红唇紫急躁易怒，即是肝经郁火上冲之征澈药用升降散疏解肝经郁滞，升降气机为先，木郁达之是也。从其舌背络脉紫黑粗大，知其血分瘀滞，伏热深重。历来察舌，只观正面舌质舌苔的变化。赵师家传有观舌背面络脉法，令患者张口，伸舌，向上挠起，暴露舌背面，其上有青筋显露两条，若粗大紫黑者即是血分瘀热较重。有时舌面浮苔满布，遍及周迫，以致观察舌质不易明了，亦可令患者挠起舌来，察其舌背之质地，是红是赤是绛，或于或燥或润，一日了然，最为准确。本案治疗过程中，患者困动恼而致病情加重，因其病本属肝热，怒为肝之志，大怒而肝气逆上，所谓五志化火，故肝热增重，头痛加剧。治之增加清泄肝胆之品。肝属木，木能生火，故舌红尖刺，是木火两盛之象，方中加入黄连，以泻心火，是实则泻其子也。配伍周全，切中病机，故服之即效。
头痛6(低血压)
王某某，女，60岁
初诊
头痛经常发作，痛在巅顶，连及前额。常自购止痛片或止痛粉止痛，颇效。脉象沉细无力，舌自润质嫩胖，有齿痕，经查血压偏低。禀赋薄弱，清阳不升，宜升和清阳方法，用代茶饮。
川芎40克，白芷10克
水煎代茶饮，不拘时候。
上方服之痛止，可与止痛片媲美。
[按]：头为诸阳之会。若清阳不能上承，则浊阴必犯清窍，而为头痛，目涩之类。患者痛在巅顶，厥阴所过；连及前额，阳明之区，其常服西药止痛，实已成瘾。姑拟代茶饮，方便饮用，以代止痛西药，坚持服用，可望戒断成瘾之西药。此方针时本病而设，川芎入厥阴，达巅顶，止巅痛，白芷入阳明，达前额，升清阳。二药合用，止头痛之效大增。故饮之即效。若不愿煎煮，用沸水浸泡亦可。
头痛7(高血压，动脉硬化)
李某，男，64岁
初诊
患高血压动脉硬化多年，经常头痛，左侧为重，两耳鸣响，心烦急躁，夜寐梦多，五心烦热。素嗜辛辣厚味，且喜饮酒。大便干结，舌红且干，脉弦细劲数。此肝经郁热上攻，络脉不通。宜用养血平肝和络方法，非常服不能成功。拟用代荼饮方法。赤白芍各30克。水煎代茶，每目三次，每次200毫升。
患者用上方坚持饮用3个月，头痛基本消失，血压平稳。
[按]：高血压动脉硬化是老年人群的常见病即使西药降压，也须长期服用，以维持疗效冲医能否有常服之方，各种中成药当然可以选用。然若能针对个体情况，拟出对症之方，选用精练之药，采服简便方法，药少而精，法简而易行，岂非患者之福音?赵师所常用的代茶饮就是一种值得推广的好方法。此方治疗高血压头痛头晕，属于阴虚阳亢血分瘀滞者疗效甚好。
所需者，持之以恒耳。
头痛(回肠淋巴滤泡增生症)
刘某某，男，39岁
初诊
头痛且胀，经常发作，胸前背后皆痛，脘腹胀满，入夜为甚，大便干结，脉象沉弦，舌白苔腻，病已三年余，两年前经某医检查确诊为回肠淋巴滤泡增生症，多方求治，遍服中西药物，疗效欠佳。现头痛每日必作。此湿热蕴郁不化，络脉痹阻，先用辛香开郁，苦泄折热方法。
荆芥6克，防风6克，藁本6克，白芷6克，赤芍10克，佩兰10克(后下)，藿香10克(后下)，大腹皮10克，槟榔10克，炒枳壳6克，青陈皮各10克，焦三仙各10克，大黄3克，七剂
二诊
药后胸痛背痛皆缓，头痛如故，痛而且重，腹胀依然，脉仍弦滑，湿郁尚未全开，继用辛香通络方法。
佩兰10克，藿香10克(上二味皆后下)，晚蚕沙10克，大腹皮10克，槟榔10克，青陈皮各10克，焦三仙各10克，水红花子10克，大黄3克，七剂
三诊
腹胀渐减，胸背疼痛未作，头痛偏右，并增牙痛，舌白糙老根厚，大便干结，3日一行，脉象弦滑，按之有力且数，热郁未清，循阳明上攻作痛，宣化之中，佐以清泄方法。
佩兰10克(后下)，藿香10克(后下)，藁本10克，晚蚕沙10克，蔓剂子10克，生石膏30克，知母10克，黄芩10克，大黄6克，瓜蒌30克，七剂
四诊
牙痛已止，头痛渐减，大便通畅，时感腹部隐痛。心烦急躁，脉象弦滑，舌红苔白，肝经郁热，横犯脾土，疏调木土方法。
柴胡6克，黄芩6克，川楝子10克，元胡10克，佩兰10克，藿香10克，藁本10克，白芷6克，晚蚕沙10克，蔓剂子10
克，大黄6克，瓜萎30克，七剂
五诊
头痛大减，二便如常，脉象弦滑，舌红苔白根厚，仍用疏调三焦方法。
柴胡6克，黄芩6克，川楝子10克，元胡10克，蔓剂子10
克，晚蚕沙10克，白芷6克，藁本10克，焦三仙各10克，水红花子10克，大腹皮10克，槟榔10克，大黄6克，瓜蒌30克，七剂
上方后头痛已止，后宗上方调理续服4周，头痛未再发作。
[按]：此证以头痛为主，兼有胸背作痛，根据舌脉征象，断为湿郁热伏，络脉痹阻，故药用辛香开郁。凡湿与热合，必先治湿，开其湿郁则热易外泄。案中始终用佩兰、藿香，欲其芳香化湿，诸多风药，以风能胜湿。凡湿胜者，当助风以平之也。况风药辛温上达，能升阳气于巅顶。所谓高巅之上，唯风可到也。三诊湿郁已开，热象显露，故增入白虎汤意，清泄阳明。终以疏调三焦，三焦者，水谷之道路，三焦畅则气机升降如序，湿热不存，故病愈。
气（药性）善于治疗头痛，所谓“头痛必用川芎”，各加引经药，如今重用此药，药力专一且疗效显著。况且其气辛温走窜，上达头顶，下抵厥阴经，配合茺蔚子活血明目，稍加煎煮即饮，取其清气上达之效，是治疗头痛的妙方，屡试屡验，若合入复方中亦可。
头痛3（高血压）
孙某某，女，37岁
初诊
脉象弦精细数，心烦多梦，大便干结，血压偏高，头痛偏左，痛如针刺。此为阴分不足，血虚不能养肝，导致肝阳化风，风动则头痛必然发作，舌红且干，是阴伤热生的征象。先用清上实下的方法。
桑叶10克，菊花10克，钩藤10克（后下），生石决明20克，生牡蛎20克，白芍10克，甘草6克，木瓜10克。
二诊
头痛略减，脉象弦细，舌红口干，再以前法，参以养血育阴，期望风息痛止。
桑叶10克，菊花10克，钩藤10克（后下），生石决明20克，生牡蛎20克，白芍10克，女贞子10克，旱莲草10克，夏枯草10克，牛膝10克。
三诊
服药后疼痛停止，睡眠安宁，仍以前法加减进退。忌食辛辣肥甘之物为关键。原方继续服用10剂。
[按语]：阴虚则阳亢，下虚则上盛，现头痛偏左，是肝热上冲所致。肝热的原因在于阴虚，故用清肝息风以治其标，养血育阴以治其本，标本兼顾，服用后即见效。
头痛4（高血压）
周某，女，54岁
初诊
形体消瘦，面色黧黑，属木火之形，急躁易怒，每于夜间睡眠不安时头痛必然发作，若遇到恼怒，疼痛更甚。脉象弦细而散，按之有力，这是阴不足而阳有余，宣泄其肝热，调和其阴分，以求疼痛停止。
柴胡6克，黄芩10克，川楝子10克，竹茹6克，枳壳6克，白芍10克，钩藤10克，生地黄10克，生石决明20克，生牡蛎20克，七剂。
上方服用七剂后疼痛减轻，又继服七剂后疼痛停止。
[按语]：此案与上一案病情相似，故用药也大致相同。案中所说“木火之形”是指形体较瘦削，面色偏黑，性情急躁者，这类患者大多肝火旺而阴分不足，其脉象弦细数，弦乃气郁之象，细主脏阴之亏，数则主热，故断为肝郁热而阴分不足，用泄肝热、平肝阳、养血育阴的方法可获效。
头痛5（三叉神经痛）
宁某某，女，42岁
初诊
患三叉神经痛多年，曾在神经科治疗。常服镇静剂西药，若停药则头痛即发。面色红赤，舌红唇紫，夜寐多梦，心烦急躁。病属木郁化火，肝热生风，络脉瘀滞之症。先当疏调气机，以解肝郁，用活血通络，以止其痛。
蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，木瓜10克，钩藤10克，大腹皮10克，槟榔10克，珍珠母20克，七剂。
二诊
服药后痛势稍缓，脉象弦数，按之有力；舌红苔黄唇紫，舌背络脉粗大紫黑，必是血分瘀滞，拟用凉血化瘀通络方：
柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，牛膝10克，川芎20克，钩藤10克（后下），生石决明20克，生牡蛎20克，珍珠母20克，蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，七剂。
三诊
痛势再减，可不服安眠药。夜晚睡眠显著改善，心情较前平静。诊脉弦数，舌红苔白，仍用前法加减。
蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，焦三仙各10克，水红花子10克，川芎20克，七剂。
四诊
近因动怒，头痛又作，夜寐不安，恶梦纷纭。五志过极，皆为火热，木火上攻，其痛必作。脉象弦数有力，舌红尖刺苔黄根厚，再以清泄肝胆方法。
柴胡6克，黄芩10克，川楝子10克，龙胆草3克，夏枯草10克，蝉衣6克，僵蚕10克，片姜黄6克，大黄2克，黄连2克，焦三仙各10克，七剂。
上方服后，头痛即止。嘱其戒恼怒，忌辛辣，戒烟酒。保持心情舒畅，每日锻炼，以防复发。
[按语]：三叉神经痛较为顽固，其人面红唇紫急躁易怒，即是肝经郁火上冲之征。药用升降散疏解肝经郁滞，升降气机为先，即“木郁达之”之意。从其舌背络脉紫黑粗大，知其血分瘀滞，伏热深重。历来察舌，只观正面舌质舌苔的变化。赵师家传有观舌背面络脉法，令患者张口，伸舌，向上翘起，暴露舌背面，其上有青筋显露两条，若粗大紫黑者即是血分瘀热较重。有时舌面浮苔满布，遍及周围，以致观察舌质不易明了，亦可令患者翘起舌头，察其舌背之质地，是红是赤是绛，或干或燥或润，一目了然，最为准确。本案治疗过程中，患者因动怒而致病情加重，因其病本属肝热，怒为肝之志，大怒而肝气逆上，所谓五志化火，故肝热增重，头痛加剧。治之增加清泄肝胆之品。肝属木，木能生火，故舌红尖刺，是木火两盛之象，方中加入黄连，以泻心火，是“实则泻其子”也。配伍周全，切中病机，故服之即效。
头痛6（低血压）
王某某，女，60岁
初诊
头痛经常发作，痛在巅顶，连及前额。常自购止痛片或止痛粉止痛，颇效。脉象沉细无力，舌自润质嫩胖，有齿痕，经查血压偏低。禀赋薄弱，清阳不升，宜升提清阳方法，用代茶饮。
川芎40克，白芷10克。
水煎代茶饮，不拘时候。
上方服之痛止，可与止痛片媲美。
[按语]：头为诸阳之会。若清阳不能上承，则浊阴必犯清窍，而为头痛、目涩之类。患者痛在巅顶，为厥阴经所过；连及前额，为阳明经之区，其常服西药止痛，实已成瘾。姑拟代茶饮，方便饮用，以代止痛西药，坚持服用，可望戒断成瘾之西药。此方针针对本病而设，川芎入厥阴经，达巅顶，止巅顶痛，白芷入阳明经，达前额，升清阳。二药合用，止头痛之效大增。故饮之即效。若不愿煎煮，用沸水浸泡亦可。
头痛7（高血压，动脉硬化）
李某，男，64岁
初诊
患高血压动脉硬化多年，经常头痛，左侧为重，两耳鸣响，心烦急躁，夜寐多梦，五心烦热。素嗜辛辣厚味，且喜饮酒。大便干结，舌红且干，脉弦细劲数。此肝经郁热上攻，络脉不通。宜用养血平肝和络方法，非常服不能成功。拟用代茶饮方法。赤白芍各30克。水煎代茶，每日三次，每次200毫升。
患者用上方坚持饮用3个月，头痛基本消失，血压平稳。
[按语]：高血压动脉硬化是老年人群的常见病，即使西药降压，也须长期服用，以维持疗效。中医能否有常服之方？各种中成药当然可以选用。然若能针对个体情况，拟出对症之方，选用精练之药，采取简便方法，药少而精，法简而易行，岂非患者之福音？赵师所常用的代茶饮就是一种值得推广的好方法。此方治疗高血压头痛头晕，属于阴虚阳亢、血分瘀滞者疗效甚好。所需者，持之以恒耳。
头痛（回肠淋巴滤泡增生症）
刘某某，男，39岁
初诊
头痛且胀，经常发作，胸前背后皆痛，脘腹胀满，入夜为甚，大便干结，脉象沉弦，舌白苔腻，病已三年余，两年前经某医检查确诊为回肠淋巴滤泡增生症，多方求治，遍服中西药物，疗效欠佳。现头痛每日必作。此湿热蕴郁不化，络脉痹阻，先用辛香开郁，苦泄折热方法。
荆芥6克，防风6克，藁本6克，白芷6克，赤芍10克，佩兰10克（后下），藿香10克（后下），大腹皮10克，槟榔10克，炒枳壳6克，青陈皮各10克，焦三仙各10克，大黄3克，七剂。
二诊
药后胸痛背痛皆缓，头痛如故，痛而且重，腹胀依然，脉仍弦滑，湿郁尚未全开，继用辛香通络方法。
佩兰10克，藿香10克（上二味皆后下），晚蚕沙10克，大腹皮10克，槟榔10克，青陈皮各10克，焦三仙各10克，水红花子10克，大黄3克，七剂。
三诊
腹胀渐减，胸背疼痛未作，头痛偏右，并增牙痛，舌白糙老根厚，大便干结，3日一行，脉象弦滑，按之有力且数，热郁未清，循阳明上攻作痛，宣化之中，佐以清泄方法。
佩兰10克（后下），藿香10克（后下），藁本10克，晚蚕沙10克，蔓荆子10克，生石膏30克，知母10克，黄芩10克，大黄6克，瓜蒌30克，七剂。
四诊
牙痛已止，头痛渐减，大便通畅，时感腹部隐痛。心烦急躁，脉象弦滑，舌红苔白，肝经郁热，横犯脾土，疏调木土方法。
柴胡6克，黄芩6克，川楝子10克，元胡10克，佩兰10克，藿香10克，藁本10克，白芷6克，晚蚕沙10克，蔓荆子10克，大黄6克，瓜蒌30克，七剂。
五诊
头痛大减，二便如常，脉象弦滑，舌红苔白根厚，仍用疏调三焦方法。
柴胡6克，黄芩6克，川楝子10克，元胡10克，蔓荆子10克，晚蚕沙10克，白芷6克，藁本10克，焦三仙各10克，水红花子10克，大腹皮10克，槟榔10克，大黄6克，瓜蒌30克，七剂。
上方后头痛已止，后宗上方调理续服4周，头痛未再发作。
[按语]：此证以头痛为主，兼有胸背作痛，根据舌脉征象，断为湿郁热伏，络脉痹阻，故药用辛香开郁。凡湿与热合，必先治湿，开其湿郁则热易外泄。案中始终用佩兰、藿香，欲其芳香化湿，诸多风药，以风能胜湿。凡湿胜者，当助风以平之也。况风药辛温上达，能升阳气于巅顶。所谓高巅之上，唯风可到也。三诊湿郁已开，热象显露，故增入白虎汤意，清泄阳明。终以疏调三焦，三焦者，水谷之道路，三焦畅则气机升降如序，湿热不存，故病愈。
Qi (medicinal property) is good at treating headache, as the saying goes, "Headache must use Chuanxiong Rhizoma (Chuanxiong), adding guiding herbs for each meridian." Now, using it in heavy doses makes the medicinal force focused and effective. Moreover, its qi is acrid and warm, moving and penetrating, reaching up to the vertex and down to the Jueyin meridian. Combined with Vitex Fruit (Chongweizi) to invigorate blood and brighten the eyes, it should be taken after slight decoction, taking advantage of its clear qi ascending to the top. It is an excellent prescription for treating headache, proven repeatedly. It can also be included in compound prescriptions.
Headache 3 (Hypertension)
Sun XX, Female, 37 years old
First Visit
The pulse is wiry, fine, rapid, and thin; there is mental restlessness and frequent dreaming; stools are dry; blood pressure is elevated; headache is on the left side, feeling like needle pricks. This indicates insufficiency of Yin aspect, blood deficiency failing to nourish the Liver, leading to Liver Yang transforming into Wind. When Wind moves, headache inevitably occurs. The tongue is red and dry, indicating Yin injury and heat generation. First, use the method of clearing the upper and solidifying the lower.
Mulberry Leaf (Sangye) 10g, Chrysanthemum Flower (Juhua) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g (added later), Raw Oyster Shell (Sheng Shijueming) 20g, Raw Pearl Shell (Sheng Muli) 20g, White Peony Root (Baishao) 10g, Licorice Root (Gancao) 6g, Papaya Fruit (Mugua) 10g.
Second Visit
Headache slightly reduced; pulse is wiry and fine; tongue is red and mouth is dry. Continue with the previous method, incorporating nourishing blood and nurturing Yin, hoping for Wind to subside and pain to stop.
Mulberry Leaf (Sangye) 10g, Chrysanthemum Flower (Juhua) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g (added later), Raw Oyster Shell (Sheng Shijueming) 20g, Raw Pearl Shell (Sheng Muli) 20g, White Peony Root (Baishao) 10g, Privet Fruit (Nvzhenzi) 10g, Eclipta Herb (Hanliancao) 10g, Prunella Spike (Xiakucao) 10g, Achyranthes Root (Niuxi) 10g.
Third Visit
After medication, pain stopped and sleep was peaceful. Still adjust the previous method according to changes. Avoiding spicy and greasy foods is essential. Continue the original prescription for 10 doses.
[Commentary]: Yin deficiency leads to Yang hyperactivity; lower deficiency leads to upper excess. Headache on the left indicates Liver Heat rushing upward. The cause of Liver Heat lies in Yin deficiency. Therefore, clear Liver Heat and extinguish Wind to treat the branch, and nourish blood and nurture Yin to treat the root. Addressing both root and branch yields immediate effect.
Headache 4 (Hypertension)
Zhou XX, Female, 54 years old
First Visit
The body is emaciated, complexion is dark, representing a Wood-Fire constitution. Irritable and prone to anger. Headache invariably occurs when sleep is poor at night; if angered, the pain worsens. The pulse is wiry, fine, and scattered, but forceful upon pressing. This indicates insufficient Yin and excessive Yang. Ventilate the Liver Heat and harmonize the Yin aspect to seek cessation of pain.
Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Bamboo Shavings (Zhuru) 6g, Aurantium Fruit (Zhiqiao) 6g, White Peony Root (Baishao) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g, Raw Rehmannia Root (Sheng Dihuang) 10g, Raw Oyster Shell (Sheng Shijueming) 20g, Raw Pearl Shell (Sheng Muli) 20g, seven doses.
After taking the above prescription for seven doses, pain decreased. Continuing for another seven doses stopped the pain.
[Commentary]: This case is similar to the previous one, so the medication is roughly the same. "Wood-Fire constitution" refers to those who are slender, have a darker complexion, and are irritable. Such patients mostly have strong Liver Fire and insufficient Yin. Their pulse is wiry, fine, and rapid: wiry indicates Qi stagnation, fine indicates deficiency of Zang Yin, and rapid indicates Heat. Thus, diagnosed as Liver Qi stagnation with Heat and insufficient Yin, using methods to drain Liver Heat, calm Liver Yang, nourish blood, and nurture Yin can be effective.
Headache 5 (Trigeminal Neuralgia)
Ning XX, Female, 42 years old
First Visit
Suffering from Trigeminal Neuralgia for years, treated in neurology department. Often takes Western sedatives; headache recurs upon stopping medication. Complexion is red, tongue is red, lips are purple, frequent dreams during sleep, mental restlessness and irritability. The disease belongs to Wood stagnation transforming into Fire, Liver Heat generating Wind, and collateral stasis. First, regulate Qi mechanism to resolve Liver stagnation, and use blood-invigorating and collateral-unblocking methods to stop pain.
Cicada Slough (Chanyi) 6g, Bombyx Batryticatus (Jiangcan) 10g, Curcuma Tuber (Pian Jianghuang) 6g, Rhubarb Root (Dahuang) 1g, Papaya Fruit (Mugua) 10g, Uncaria Ramulus cum Uncis (Gouteng) 10g, Areca Seed (Fupipi/Daren) 10g, Betel Nut (Binglang) 10g, Mother of Pearl (Zhenzhumu) 20g, seven doses.
Second Visit
Pain intensity slightly eased after medication; pulse is wiry and rapid, forceful upon pressing; tongue is red with yellow coating, lips are purple; dorsal lingual veins are thick, purple, and black, indicating Blood stasis. Prescribe a formula to cool Blood, transform stasis, and unblock collaterals:
Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Achyranthes Root (Niuxi) 10g, Chuanxiong Rhizoma (Chuanxiong) 20g, Uncaria Ramulus cum Uncis (Gouteng) 10g (added later), Raw Oyster Shell (Sheng Shijueming) 20g, Raw Pearl Shell (Sheng Muli) 20g, Mother of Pearl (Zhenzhumu) 20g, Cicada Slough (Chanyi) 6g, Bombyx Batryticatus (Jiangcan) 10g, Curcuma Tuber (Pian Jianghuang) 6g, Rhubarb Root (Dahuang) 1g, seven doses.
Third Visit
Pain intensity further reduced; sleeping pills no longer needed. Night sleep significantly improved, mood calmer than before. Pulse is wiry and rapid; tongue is red with white coating. Still use previous method with modifications.
Cicada Slough (Chanyi) 6g, Bombyx Batryticatus (Jiangcan) 10g, Curcuma Tuber (Pian Jianghuang) 6g, Rhubarb Root (Dahuang) 1g, Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Salvia Root (Danshen) 10g, Rubia Root (Qiancao) 10g, Charred Three Immortals (Jiao Sanxian) 10g each, Hydrangea Seed (Shuihonghua Zi) 10g, Chuanxiong Rhizoma (Chuanxiong) 20g, seven doses.
Fourth Visit
Recently due to anger, headache recurred, sleep uneasy with nightmares. Extreme emotions all transform into Fire; Wood Fire attacking upward causes pain. Pulse is wiry, rapid, and forceful; tongue tip is prickly red, coating yellow and thick at root. Use method to clear and drain Liver and Gallbladder.
Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 10g, Toosendan Fruit (Chuanlianzi) 10g, Gentian Root (Longdancao) 3g, Prunella Spike (Xiakucao) 10g, Cicada Slough (Chanyi) 6g, Bombyx Batryticatus (Jiangcan) 10g, Curcuma Tuber (Pian Jianghuang) 6g, Rhubarb Root (Dahuang) 2g, Coptis Rhizome (Huanglian) 2g, Charred Three Immortals (Jiao Sanxian) 10g each, seven doses.
After taking the above prescription, headache stopped immediately. Advised to avoid anger, spicy food, smoking, and alcohol. Maintain cheerful mood, exercise daily to prevent recurrence.
[Commentary]: Trigeminal neuralgia is stubborn. Red face, purple lips, irritability, and anger are signs of Liver Meridian Stagnant Fire rushing upward. Using Shengjiang San to resolve Liver Meridian stagnation, prioritizing regulating Qi mechanism, follows the principle "When Wood is stagnant, disperse it." From the thick, purple-black dorsal lingual veins, we know there is Blood stasis and deep-seated latent Heat. Traditionally, tongue diagnosis only observes the front surface quality and coating. Master Zhao's family tradition includes observing dorsal lingual veins: ask patient to open mouth, extend tongue, curl it up to expose the back. Two blue veins appear; if thick, purple, and black, it indicates severe Blood stasis and Heat. Sometimes floating coating covers the whole tongue, making observation difficult; lifting the tongue reveals the dorsal texture—red, crimson, or scarlet, dry, moist, etc.—clearly seen, most accurate. During treatment, patient's condition worsened due to anger. Since the root is Liver Heat, and anger is the emotion of Liver, great anger causes Liver Qi to reverse upward, known as "Five Emotions Transform into Fire," thus increasing Liver Heat and headache. Treatment added herbs to clear and drain Liver and Gallbladder. Liver belongs to Wood, Wood generates Fire, hence red prickly tongue tip indicates Wood and Fire both flourishing. Added Coptis Rhizome (Huanglian) to drain Heart Fire, following "Excess drains its child." Comprehensive compatibility hits the pathogenesis, yielding immediate effect.
Headache 6 (Hypotension)
Wang XX, Female, 60 years old
First Visit
Headache frequently occurs, pain at the vertex, radiating to the forehead. Often buys painkillers or analgesic powder for relief, quite effective. Pulse is deep, fine, and weak; tongue is naturally moist, tender, fat, with teeth marks; checked blood pressure is low. Weak constitution, Clear Yang fails to ascend. Suitable method is to raise Clear Yang, using tea substitute.
Chuanxiong Rhizoma (Chuanxiong) 40g, Angelica Dahurica Root (Baizhi) 10g.
Decoct in water as tea substitute, anytime.
After taking the above prescription, pain stopped, comparable to painkillers.
[Commentary]: The head is the meeting place of all Yang meridians. If Clear Yang cannot ascend, Turbid Yin will invade clear orifices, causing headache and dry eyes. Pain at the vertex passes through the Jueyin meridian; radiating to the forehead is the area of the Yangming meridian. Frequent use of Western painkillers has led to addiction. Tentatively prescribe tea substitute for convenience, replacing Western painkillers. Persistent use may help withdraw from addictive Western drugs. This approach targets the disease itself. Chuanxiong enters Jueyin, reaches the vertex, stops vertex pain; Baizhi enters Yangming, reaches the forehead, raises Clear Yang. The two combined greatly enhance headache relief. Hence, effective upon drinking. If unwilling to decoct, steeping in boiling water is also acceptable.
Headache 7 (Hypertension, Arteriosclerosis)
Li XX, Male, 64 years old
First Visit
Suffering from Hypertension and Arteriosclerosis for years, frequent headaches, heavier on the left, tinnitus in both ears, mental restlessness and irritability, frequent dreams, five-palm heat. Accustomed to spicy and rich foods, likes drinking alcohol. Stools are dry, tongue is red and dry, pulse is wiry, fine, stiff, and rapid. This is Liver Meridian Stagnant Fire attacking upward, collaterals blocked. Suitable method is nourishing blood, calming Liver, and harmonizing collaterals. Cannot succeed without long-term use. Prescribe tea substitute method. Red and White Peony Roots (Chi Baishao) 30g each. Decoct in water as tea, three times daily, 200ml each time.
Patient persisted in drinking the above prescription for 3 months; headache basically disappeared, blood pressure stabilized.
[Commentary]: Hypertension and arteriosclerosis are common in the elderly. Even with Western antihypertensives, long-term use is required to maintain efficacy. Can Traditional Chinese Medicine offer a prescription for long-term use? Various patent medicines can certainly be selected. However, if one can formulate a targeted prescription based on individual conditions, select refined herbs, adopt simple methods, with few but potent herbs and simple yet executable methods, would this not be a blessing for patients? Tea substitutes commonly used by Master Zhao are a good method worth promoting. This prescription treats headache and dizziness in hypertension, showing excellent efficacy for cases of Yin deficiency with Yang hyperactivity and Blood stasis. What is needed is perseverance.
Headache (Ileal Lymphoid Follicular Hyperplasia)
Liu XX, Male, 39 years old
First Visit
Headache with distension, frequent occurrence, pain in chest and back, abdominal fullness, worse at night, dry stools, pulse is deep and wiry, tongue white with greasy coating. Disease for over three years, diagnosed as Ileal Lymphoid Follicular Hyperplasia two years ago by another doctor. Sought various treatments, took many Chinese and Western medicines, poor efficacy. Now headache occurs daily. This is Damp-Heat accumulating and stagnating, collaterals obstructed. First use acrid-aromatic to open stagnation, bitter-draining to reduce Heat.
Schizonepeta Spike (Jingjie) 6g, Saposhnikovia Root (Fangfeng) 6g, Ligusticum Wallichii Rhizome (Gaoben) 6g, Angelica Dahurica Root (Baizhi) 6g, Red Peony Root (Chishao) 10g, Eupatorium Perfoliatum Herb (Peilan) 10g (added later), Agastache Herb (Huoxiang) 10g (added later), Areca Peel (Fupipi) 10g, Betel Nut (Binglang) 10g, Stir-fried Aurantium Fruit (Chao Zhiqiao) 6g, Green and Aged Tangerine Peel (Qing Chenpi) 10g each, Charred Three Immortals (Jiao Sanxian) 10g each, Rhubarb Root (Dahuang) 3g, seven doses.
Second Visit
Chest and back pain eased after medication, headache remains, painful and heavy, abdominal distension persists, pulse still wiry and slippery, Damp stagnation not fully opened. Continue with acrid-aromatic to unblock collaterals method.
Eupatorium Perfoliatum Herb (Peilan) 10g, Agastache Herb (Huoxiang) 10g (both added later), Silkworm Excrement (Wancansha) 10g, Areca Peel (Fupipi) 10g, Betel Nut (Binglang) 10g, Green and Aged Tangerine Peel (Qing Chenpi) 10g each, Charred Three Immortals (Jiao Sanxian) 10g each, Hydrangea Seed (Shuihonghua Zi) 10g, Rhubarb Root (Dahuang) 3g, seven doses.
Third Visit
Abdominal distension gradually reduced, chest and back pain did not recur, headache shifted to right, plus toothache. Tongue white, rough, old, thick at root, dry stools, once every 3 days, pulse wiry and slippery, forceful and rapid upon pressing, Heat stagnation not cleared, following Yangming ascending to cause pain. In resolving transformation, assist with clearing and draining method.
Eupatorium Perfoliatum Herb (Peilan) 10g (added later), Agastache Herb (Huoxiang) 10g (added later), Ligusticum Wallichii Rhizome (Gaoben) 10g, Silkworm Excrement (Wancansha) 10g, Vitex Fruit (Manjingzi) 10g, Raw Gypsum (Sheng Shigao) 30g, Anemarrhena Rhizome (Zhimu) 10g, Scutellaria Root (Huangqin) 10g, Rhubarb Root (Dahuang) 6g, Trichosanthes Fruit (Gualou) 30g, seven doses.
Fourth Visit
Toothache stopped, headache gradually reduced, bowel movement smooth, occasional dull abdominal pain. Mental restlessness and irritability, pulse wiry and slippery, tongue red with white coating. Liver Meridian Stagnant Heat invading Spleen Earth horizontally. Method to regulate Wood and Earth.
Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 6g, Toosendan Fruit (Chuanlianzi) 10g, Corydalis Rhizome (Yanhu) 10g, Eupatorium Perfoliatum Herb (Peilan) 10g, Agastache Herb (Huoxiang) 10g, Ligusticum Wallichii Rhizome (Gaoben) 10g, Angelica Dahurica Root (Baizhi) 6g, Silkworm Excrement (Wancansha) 10g, Vitex Fruit (Manjingzi) 10g, Rhubarb Root (Dahuang) 6g, Trichosanthes Fruit (Gualou) 30g, seven doses.
Fifth Visit
Headache greatly reduced, urination and defecation normal, pulse wiry and slippery, tongue red with white coating thick at root. Still use method to regulate Triple Burner.
Bupleurum Root (Chaihu) 6g, Scutellaria Root (Huangqin) 6g, Toosendan Fruit (Chuanlianzi) 10g, Corydalis Rhizome (Yanhu) 10g, Vitex Fruit (Manjingzi) 10g, Silkworm Excrement (Wancansha) 10g, Angelica Dahurica Root (Baizhi) 6g, Ligusticum Wallichii Rhizome (Gaoben) 10g, Charred Three Immortals (Jiao Sanxian) 10g each, Hydrangea Seed (Shuihonghua Zi) 10g, Areca Peel (Fupipi) 10g, Betel Nut (Binglang) 10g, Rhubarb Root (Dahuang) 6g, Trichosanthes Fruit (Gualou) 30g, seven doses.
After the above prescription, headache stopped. Subsequently continued the above prescription for regulation for 4 weeks, headache did not recur.
[Commentary]: This syndrome is mainly headache, accompanied by chest and back pain. Based on tongue and pulse signs, diagnosed as Damp stagnation with latent Heat, collateral obstruction, hence using acrid-aromatic to open stagnation. Whenever Damp and Heat combine, treat Damp first; opening Damp stagnation allows Heat to escape easily. Throughout the case, Peilan and Huoxiang were always used for their aromatic damp-resolving properties, along with many Wind-dispersing herbs, as Wind can overcome Damp. For excessive Damp, aid Wind to pacify it. Moreover, Wind herbs are acrid, warm, and ascending, able to raise Yang Qi to the vertex. As the saying goes, "Only Wind can reach the high vertex." In the third visit, Damp stagnation opened, Heat signs appeared, so added Baihu Tang intent to clear and drain Yangming. Finally, regulate Triple Burner. Triple Burner is the pathway of water and grain; when Triple Burner is smooth, Qi mechanism ascends and descends in order, Damp-Heat does not remain, thus the disease heals.